Looking for advice here if Accutane can do much for my cystic acne that comes across during my monthly periods.

I had been on Accutane before for 4 months and I was cleared. I was so happy with the result despite all its reported negative side effects. But honestly, it was more of positive for me seeing the dramatic results on my skin. Since then my acne is controlled.

Just recently I notice that I ALWAYS never missed to have 2-3 cystic acne during my period. Actually, a week before and during my period. They are huge, painful, and only appears on my chin and on the sides of my mouth. My cheeks and forehead are all clear. I don't really mind getting 2 acne a month but the impact of the cystic acne on my face is really bad. It always tends to heal slowly and scar deeply. The fight for getting rid of those scars is really tough.

Now my dermatologist wants to put me back on Accutane to stop the cystic acne from coming. Not sure if this is a good idea?

I don't wanna try Spiro. Currently, I am on Saw Palmetto, though it has been 2 weeks only and could not justify the effect yet. But I think I'm gonna give it up. My libido has decreased immensely. I am also on BCP.